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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Pretreatment aberrant DNA methylation patterns are stable at time of relapse in acute lymphocytic leukemia (ALL).

We hypothesized that the detection of residual methylation alterations at the time of morphologic remission may predict for worse prognosis.

We developed a real-time bisulfite polymerase chain reaction assay and analyzed the methylation levels of p73, p15, and p57(KIP2) at the time of initial remission in 199 patients with Philadelphia chromosome-negative and MLL(-) ALL.

In 123 (65%) patients, matched pretreatment samples were also studied and compared with remission ones: in 82 of those with initial aberrant methylation of at least one gene, 59 (72%) had no detectable methylation at remission and 23 (28%) had detectable residual methylation.

METHODS: A total of 1541 patients referred for remission induction chemotherapy of AML or high-risk myelodysplastic syndrome were retrospectively reviewed.

RESULTS: A total of 120 (8%) patients developed acute pulmonary failure within 2 weeks of the initiation of chemotherapy; 87 of these patients (73%) died during remission induction, whereas 17 (14%) achieved a complete response.

The median survival among the 120 patients with early acute pulmonary failure was 3 weeks.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: Potential cure of acute myeloid leukemia (AML) is now a widely accepted idea, but it is uncertain whether there is heterogeneity in the failure rate in patients once they have been in complete remission (CR) for various periods of time.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We analyzed the incidence and prognostic value of TET2 point mutations and other genomic alterations by direct sequencing and single nucleotide polymorphism microarray analysis in 111 de novo acute myeloid leukemia, who had all achieved complete remission (CR).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Impact of different post-remission strategies on quality of life in patients with acute myeloid leukemia.

BACKGROUND: The impact on quality of life of allogeneic stem cell transplantation or conventional chemotherapy in patients with acute myeloid leukemia remains unclear, mainly because of a lack of studies with long-term follow-up.

One hundred and seventy patients were treated with stem cell transplantation (121 allogenic, 49 autologous) in first complete remission; the other 249 patients were treated with conventional chemotherapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking.

The remission intention (RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown.

The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries.

Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

: 7049 Since the activation-induced cytidine deaminase (AID) enzyme can target non-immunoglobulin (Ig) genes and may even act as a genome-wide mutator, we investigated AID expression in BCR-ABL1-positive ALL and in chronic myeloid leukemia (CML) at the time of progression to blast crisis.

On the 61 de novo adult BCR-ABL1-positive ALL patients (pts), AID mRNA and protein were detected in 36 (59%); their expression correlated with BCR-ABL1 transcript levels and disappeared after treatment with tyrosine kinase inhibitors at the time of remission.

Our findings show that BCR-ABL1-positive ALL cells aberrantly express different isoforms of AID that can act as mutator outside the Ig gene loci in promoting genetic instability in leukemia cells.

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(PMID = 27961429.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Pretransplant comorbidity as an outcome predictor in adult patients younger than 60 years of age receiving standard induction chemotherapy for de novo acute myeloid leukemia.

: 7055 Background: Comorbidity has been evaluated as an outcome predictor in elderly patients receiving induction chemotherapy for acute myeloid leukemia (AML) as well as in patients undergoing allogeneic hematopoietic cell transplantation (HCT) for various hematologic disorders.

RESULTS: In the univariate analyses, the HCT-CI score was not a significant prognostic factor for induction of complete remission (CR), whereas survival outcomes such as overall survival (OS), relapse-free survival (RFS) and event-free survival (EFS) were significantly different according to the HCT-CI scores (Table).

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(PMID = 27961421.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Title] Etoposide and mitoxantrone in newly diagnosed acute myeloid leukemia patients with persistent leukemia after a course of induction therapy with cytarabine and idarubicin.

If residual leukemia is present after the first course of induction therapy, patients receive a second course identical to the first or receive a non-cross resistant antileukemic regimen.

METHODS: In a retrospective study of adult patients with newly-diagnosed AML treated at the University of Pittsburgh Cancer Institute between December 2002 and May 2008, we evaluated the efficacy and toxicity of mitoxantrone (10 mg/m<sup>2</sup>/d) and etoposide (100 mg/m<sup>2</sup>/d), both administered intravenously within 5 days as second course therapy of patients not responding to first-course induction therapy with cytarabine and idarubicin.

CONCLUSIONS: Our study suggests that the combination of etoposide and mitoxantorne is an active and well-tolerated regimen as second-course therapy in newly diagnosed AML patients who have persistent leukemia after a first course of induction therapy with cytarabine and idarubicin.

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(PMID = 27961456.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Based on these findings and encouraging results of the addition of cladribine to standard daunorubicin+Ara-C induction regimen (DAC) in acute myeloid leukemia (AML), the Polish Adult Leukemia Group (PALG) conducted a pilot study on the administration of cytarabine, daunorubicin, and fludarabine (DAF) as a reinduction treatment of AML to assess tolerance, toxicity, and early outcome.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We report the retrospective outcomes of unrelated donor (URD) transplants in 169 patients with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) who received transplants between 1995 and 2004.

A total of 50% had a white blood cell count (WBC) more than 30 x 10(9)/L, 18% extramedullary disease, 42% achieved CR more than 8 weeks from diagnosis, 25% had adverse cytogenetics, and 19% had T-cell leukemia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The anti-leukemic activity of NK cells against acute myeloid leukemia (AML) blasts has been described, but very few data are available for acute lymphoid leukemia (ALL).

The present study was designed to investigate whether: (i) NK effectors could be expanded from adult and pediatric ALL patients in complete remission;.

(v) any differences in cytotoxic activity could be found between expanded effectors from adult and pediatric patients.

No differences in expansion and cytotoxic activity were found between pediatric and adult patients.

INTERPRETATION AND CONCLUSIONS: These findings document for the first time the possibility of expanding ex vivo cytotoxic effectors with autologous killing capacity from ALL patients in remission, and suggest a new potential immunotherapeutic strategy for the management of early disease recurrence or of residual disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE OF REVIEW: Allogeneic hematopoietic cell transplantation with myeloablative conditioning is a well established therapy for patients with acute myeloid leukemia.

Its efficacy depends, in part, on the destruction of recipient acute myeloid leukemia cells by the conditioning regimen and, in part on their removal by donor immune cells contained in the graft (graft-versus-tumor effect).

RECENT FINDINGS: Early results with allogeneic hematopoietic cell transplantation after nonmyeloablative and reduced-intensity conditioning for patients with acute myeloid leukemia in first complete remission are encouraging, with 2-year survivals after hematopoietic cell transplantation ranging from 48 to 79% among studies.

Further, retrospective studies have demonstrated similar outcomes in adult patients with acute myeloid leukemia in complete remission given either myeloablative or nonmyeloablative conditioning.

SUMMARY: Prospective studies are needed to define the place of allogeneic hematopoietic cell transplantation after nonmyeloablative or reduced-intensity conditioning in patients with acute myeloid leukemia in complete remission, and to determine a role for consolidation chemotherapy before hematopoietic cell transplantation, if any.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Hyperglycemia adversely affects outcome in adult patients with acute lymphoblastic leukemia (ALL), but its impact on children with this disease is unknown.

We evaluated the relationship between hyperglycemia during remission induction therapy and clinical outcomes among pediatric patients with ALL.

We reviewed the records of patients enrolled on four consecutive ALL protocols (Total Therapy protocols XIIIA, XIIIB, XIV and XV) at St Jude Children's Research Hospital from 1991 to 2007 and identified those who experienced hyperglycemia (glucose >or=200 mg per 100 ml) during remission induction.

Complete remission (CR) rates at the end of induction, event-free survival (EFS), overall survival (OS), cumulative incidence of relapse and occurrence of infections were compared between those who did and did not experience hyperglycemia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The outcome of sibling and unrelated donor allogeneic stem cell transplantation in adult patients with acute myeloid leukemia in first remission who were initially refractory to first induction chemotherapy.

The optimal management of patients with initially refractory acute myeloid leukemia is unknown.

We analyzed the outcomes of 68 adult patients (median age, 37 years) with acute myeloid leukemia in first complete remission with initially refractory disease who were treated with matched sibling (n=44) or unrelated donor (n=22) stem cell transplantation or who received transplants from other donors (n=2).

Thirty-one patients took 2 courses of chemotherapy to achieve first complete remission, a further 31 took 3 courses, and 6 patients took 4 or 5 courses.

Grades II to IV and III/IV acute graft-versus-host disease (GVHD) were seen in 34% and 14% of patients, respectively.

Approximately one third of patients survived 4 years after allogeneic stem cell transplantation for initially refractory acute myeloid leukemia in first complete remission: relapse and treatment-related mortality were the major causes of treatment failure.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Effects of FLAG protocol in treatment of the first time induced non-remission acute myeloid leukemia].

In order to evaluate the efficacy of FLAG protocol (fludarabine, cytosine arabinoside and granulocyte colony-stimulating factor) in treatment of the first time induced non-remission acute myeloid leukemia (AML), 19 patients with first time induced non-remission acute myeloid leukemia were treated with FLAG protocol.

The results showed that out of the 19 patients 13 patients obtained complete remission (CR) and the CR rate was 68.4%, 2 patients obtained partial remission (PR) and the PR rate was 10.5%, the overall remission rate was 78.9%.

It is concluded that the FLAG protocol should be employed for the the first time induced non-remission patients as early as possible, and provides conditions for the hematopoietic stem cell transplantation.

To assess its potency of unrelated patients in first complete-remission (CR1) transplanted from unrelated donors and the potential prognostic factors affecting the probability of survival, we retrospectively analyzed a total of 41 adult Ph(-) ALL patients in CR1 who underwent unrelated bone marrow transplantation at 6 transplantation centers of the Nagoya Blood and Marrow Transplantation Group between 1993 and 2006.

Leukemia-free survival (LFS) at 3 and 6 years from allo-SCT was 60.3 and 47.7%, respectively.

Our study suggested that unrelated allo-SCT could improve LFS of patients with a potential graft-versus-leukemia effect.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Clinico-hematological profile in biphenotypic acute leukemia.

We included those cases, which fulfilled the European Group for the Immunological Characterization of Acute Leukemia's (EGIL's) scoring system criteria for the diagnosis of BAL, as per recommendation of the WHO classification.

Fifteen patients received chemotherapy; eight achieved complete remission (CR) at the end of the induction period.

BCR-ABL expression is an important prognostic factor, as these cases will be labeled as Chronic myeloid leukemia (CML) in blast crisis with biphenotypic expression and treated accordingly.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Remission re-induction chemotherapy with clofarabine, topotecan, thiotepa, and vinorelbine for patients with relapsed or refractory leukemia.

BACKGROUND: We determined the maximum tolerated dose (MTD) of clofarabine when administered with topotecan, vinorelbine, thiotepa, and dexamethasone (TVTC) for children with relapsed or refractory acute leukemia, and observed the efficacy and toxicities of this therapy.

PROCEDURE: Twelve patients with acute lymphoblastic or myeloblastic leukemia were given a 14-day remission induction therapy.

Patients who achieved a remission proceeded to a stem cell transplant (HSCT).

One patient died on day 45 with marrow hypoplasia without evidence of leukemia.

CONCLUSION: TVTC has significant anti-leukemic activity in both acute lymphoblastic and myeloblastic leukemia.

This is the recommended dose for the phase II study in patients with refractory or relapsed leukemia, a population which has limited therapeutic options.

Of 503 patients aged 15-50 years old registered between December 1997 and July 2001, 392 achieved complete remission (CR).

The OS benefit was seen in the patients aged 36-50 years old (49 vs. 24%; p = 0.031), suggesting an advantage of allo-HSCT among older patients with leukemia that is more resistant to chemotherapy than that among younger patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Low-dose cytarabine and calcitriol (LDCA + VD3) combination therapy was performed in two adult patients with acute myeloid leukemia (AML) that relapsed within 1 yr after unrelated donor cord blood transplantation (URD CBT) performed in a relapse or non-remission stage.

Remission because of recovery of donor cord blood hematopoiesis was obtained in both patients.

The patients were followed as outpatients after remission, and the remission duration was approximately 6 months in both patients.

To identify factors to improve the outcomes of related and unrelated allogeneic stem cell transplantations (allo-SCT) for Philadelphia chromosome-negative acute lymphocytic leukemia (Ph(-) ALL) in the first complete remission (CR1), we retrospectively analyzed 1139 Ph(-) ALL patients using the registry data, particularly the details of 641 patients transplanted in CR1.

After a close consideration of these factors, the outcome of allo-SCT for adult Ph(-) ALL in CR1 could be improved.

While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL.

We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

This study was purposed to evaluate the outcome of patients with acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in complete remission, and to study the prognostic factors.

75 cases of AML in complete remission receiving allo-HSCT from January 2000 to December 2007 were retrospectively analyzed.

The results indicated that PRAME mRNA was expressed in 42.9% AML patients (n=24) and 20% ALL patients (n=4), also in two leukemia cell-lines K562 and U937, but not in eight health donors and seven ITP patients.

PRAME mRNA expression in complete remission group seems much higher than those in partial complete remission group and death group.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Post-remission treatment for adult patients with acute lymphoblastic leukemia in first remission: is there a role for autologous stem cell transplantation?

Allogeneic stem cell transplantation (alloSCT) or autologous SCT (autoSCT) and intensive consolidation/intensification courses plus maintenance chemotherapy for 1 to 2 years are currently the major options for post-remission treatment of adult patients with acute lymphoblastic leukemia (ALL) in first remission.

Herein, we try to dissect data from these randomized trials to evaluate the role of autoSCT in patients with ALL in complete remission.

A total of 22 patients with acute myeloid leukemia (AML) in first complete remission receiving autologous blood stem cell transplantation (ABSCT) were investigated in order to determine factors affecting outcome.

All but two patients had a normal karyotype and received the same high-dose chemotherapy followed by G-CSF-mobilized peripheral blood stem cells after the second (n=5) or third (n=17) course of induction and post-remission chemotherapy, respectively.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Low expression of APAF-1XL in acute myeloid leukemia may be associated with the failure of remission induction therapy.

In the present study, the mRNA expression analysis of different APAF-1 transcripts (APAF-1S, APAF-1LC, APAF-1LN, and APAF-1XL) was analyzed in bone marrow samples from 37 patients with acute myeloid leukemia (newly diagnosed, with no previous treatment).

Only 46% of the patients presented complete remission in response to remission induction therapy (represented by less than 5% marrow blasts and hematological recovery), all but 2 cases being from group 1, 21.6% did not attain complete remission (only 1 case from group 1), and 32.4% of the patients died early.

Since it has been shown that only the isoforms with the extra WD-40 repeat region activate procaspase-9, we suggest that low procaspase-9 activation may also be involved in the deregulation of apoptosis and chemotherapy resistance in acute myeloid leukemia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Influential factors for the collection of peripheral blood stem cells and engraftment in acute myeloid leukemia patients in first complete remission.

Although several studies have investigated factors influencing peripheral blood stem cell (PBSC) mobilization in patients with nonmyeloid malignancies in an effort to increase the efficiency of autologous PBSC transplantation (APBSCT), there are very few reports on the efficiency of PBSC mobilization in patients with leukemia.

We analyzed the effects of influential variables on successful mobilization and the correlation between infused cell doses and engraftment in acute myeloid leukemia (AML) patients in first complete remission (CR1) who received APBSCT.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Post-remission options were compared in a population of 262 relapsing and refractory acute myeloid leukemia patients achieving complete remission (CR) after the same re-induction according to etoposide - mitoxantrone - cytarabine (EMA) trials.

The selection of post-remission therapy depended on trial recommendations, age, performance status, and availability of an HLA-identical sibling.

A statistical model was conceived with adjustment on prognostic factors and post-remission option.

This indicates a high treatment-related toxicity with allogeneic BMT in patients re-induced by highly intensive chemotherapy, and therefore a tendency for a better outcome with autologous SCT as post-remission treatment in those patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

This study was designed to investigate the effects of cyclosporine A (CsA) on a multidrug resistance cultured cell line, and its effect on complete remission in patients with acute myeloid leukemia (AML).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Autologous stem cell transplantation in adults with acute lymphoblastic leukemia in first complete remission: analysis of the LALA-85, -87 and -94 trials.

To evaluate the results of autologous stem cell transplantation (ASCT) in a large population of adults with acute lymphoblastic leukemia (ALL) in first complete remission (CR), we performed an individual data-based overview of the last three trials from the LALA group.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: While socioeconomic status (SES) and the distance patients travel to a treatment center (DTC) impact survival of certain solid tumors, little is known of their influence in acute myeloid leukemia (AML).

METHODS: We retrospectively reviewed patients receiving remission induction therapy for AML at the Cleveland Clinic between January 1997 and December 2005.

A myeloablative conditioning regimen incorporating daily intravenous busulfan, fludarabine, and 400 cGy total-body irradiation was given before allogeneic stem cell transplantation (SCT) to 64 adults with acute leukemia in first and second remission.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Assessment of malnutrition in adult acute leukemia cases.

INTRODUCTION: This study examined malnutrition in acute leukemia cases, and its association to the treatment.

METHODS: 54 cases, consisting of 40 patients with acute myeloblastic leukemia (AML) and 14 patients with acute lymphoblastic leukemia (ALL) were included to the study, where further 34 healthy subjects were also recruited.

RESULTS: When classified according to BMI, prevalence of malnutrition was 18.5% in all cases, 18% in newly-diagnosed cases, 20% in patients with remission and 16% without remission, and 5.8% in control group.

CONCLUSIONS: Prevalence of malnutrition was seen at higher percentage in adult acute leukemia cases, which was increased during the course of treatment, and TST measurement was better in establishing malnutrition.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Early allogeneic stem-cell transplantation for young adults with acute myeloblastic leukemia in first complete remission: an intent-to-treat long-term analysis of the BGMT experience.

PURPOSE: We analyzed the impact of allogeneic stem-cell transplantation (alloSCT) as an early consolidation for young patients with acute myeloblastic leukemia in first complete remission (CR1) through four successive protocols.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] CTLA-4 genotype and relapse incidence in patients with acute myeloid leukemia in first complete remission after induction chemotherapy.

However, the contribution of the CTLA4 genotype to the control of minimal residual disease in patients with acute myeloid leukemia (AML) has yet to be explored.

We investigated the association between the CTLA4 CT60 A/G genotype and the incidence of leukemic relapse in 143 adult patients with AML in first complete remission after the same chemotherapy protocol (CETLAM LAM'03).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Higher incidence of relapse in patients with acute myelocytic leukemia infused with higher doses of CD34+ cells from leukapheresis products autografted during the first remission.

We previously showed that relapse incidence in patients with acute myelocytic leukemia autografted in first remission (CR1) was greater with PB than bone marrow, and a poorer outcome was associated with a shorter CR1 to PB transplantation interval (≤ 80 days).

[Publication-country] Egypt

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Treating the "older" adult with acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) in adults is a rare disease.

This article describes the results of chemotherapy and blood and marrow transplantation for Philadelphia chromosome negative and positive adult ALL in the "older" adult patient, but also critically examines the major controversies and suggests how they might be resolved.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Survival in adults with acute myelogenous leukemia].

BACKGROUND: Acute myelogenous leukemia is the most common type of acute leukemia in adults.

The condition is lethal within a few months without treatment, but most young patients reach complete remission with chemotherapy.

MATERIAL AND METHODS: Survival data were retrieved from the Norwegian Registry for Acute Leukemias and Lymphoblastic Lymphomas for patients with acute myelogenous leukemia (aged from 16 to 60 years) who were registered in the period 1.1.2000-31.12.2005.

Patients with secondary acute myelogenous leukemia were classified as high-risk.

BACKGROUND AND OBJECTIVES: The optimal post-remission therapy for adults with high-risk acute lymphoblastic leukemia (ALL) is not well established.

This multicenter randomized trial by the Spanish PETHEMA Group was addressed to compare three options of post-remission therapy in adults with high-risk ALL: chemotherapy, allogeneic stem cell transplantation (SCT) and autologous SCT.

Patients in complete remission with an HLA-identical family donor were assigned to allogeneic SCT (n=84) and the remaining were randomized to autologous SCT (n=50) or to delayed intensification followed by maintenance chemotherapy up to 2 years in complete remission (n=48).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

A pilot study was undertaken to assess the safety, activity, and immunogenicity of a polyvalent Wilms tumor gene 1 (WT1) peptide vaccine in patients with acute myeloid leukemia in complete remission but with molecular evidence of WT1 transcript.

Further studies are needed to establish the role of vaccination as viable postremission therapy for acute myeloid leukemia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Expressions of cyclin B1 and p21cipl in adult acute leukemia and their correlation.

To investigate the clinical significance of cyclin B1, the expression of cyclin B1 in acute leukemia (AL) patients was measured; the expression of cyclin B1 and p21(cipl), and their cell cycle distribution were assayed by flow cytometry in 136 adult patients with newly diagnosed AL, 10 continuous complete remission (CCR) AL and 17 normal controls; the mRNA of cyclin B1 and p21(cipl), and the proliferation cell nuclear antigen (PCNA) in patients and normal controls were detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).

For the relapsed AL patients, the cyclin B1 expression was also higher than that in normal controls, but lower than that in newly diagnosed cases, there was no significant difference between the remission cases and normal controls, nor difference between CCR AL patients and normal controls.

The response rate (partial remission + complete remission) and survival rate in the cyclin B1 high expressed patients were higher than that of cyclin B1 low expressed patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: The possibility of performing syngeneic hematopoietic stem cell transplantation is rare and there are concerns about the absence of a graft-versus-leukemia effect following such a strategy.

We report the outcomes of a large series of adult patients who underwent syngeneic hematopoietic stem cell transplantation for acute myeloblastic leukemia or acute lymphoblastic leukemia.

DESIGN AND METHODS: The outcomes of all syngeneic transplants for acute myeloblastic or lymphoblastic leukemia reported to the European Group for Blood and Marrow Transplantation registry were analyzed; a study of prognostic factors was performed for those transplanted in first complete remission.

RESULTS: One hundred and sixty-two patients, 109 with acute myeloblastic leukemia and 53 with acute lymphoblastic leukemia, were identified; 116 were in first complete remission.

Nineteen patients developed acute graft-versus-host disease and only three patients developed chronic graft-versus-host disease.

At 5 years the non-relapse mortality was 8 +/- 5%, the relapse incidence 49 +/- 8% and the leukemia-free survival 43 +/- 3%.

The corresponding figures for patients in first complete remission were 7 +/- 2%, 40 +/- 4% and 53 +/- 5% at 5 years.

Analysis of patients in first complete remission showed that the number of courses of chemotherapy required to induce first complete remission was the main risk factor: the leukemia-free survival at 5 years was 66 +/- 6% when first complete remission was reached after one induction course of chemotherapy and was only 20 +/- 9% when first complete remission was reached after at least two induction courses of chemotherapy (p = 0.0001); the relapse incidence was 30 +/- 6% and 54 +/- 10%, respectively (p = 0.007).

CONCLUSIONS: Outcomes were better for patients transplanted in first complete remission than in second complete remission or a more advanced phase of the disease.

When a syngeneic donor is available for patients with high risk acute leukemia, allotransplantation should be performed as soon as the first complete remission has been achieved, ideally with one course of chemotherapy.

[Publication-country] Italy

[Chemical-registry-number] 0 / Antineoplastic Agents

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Treatment of adult acute lymphoblastic leukemia.

Treatment results in adult acute lymphoblastic leukemia (ALL) have improved considerably in the past decade, with an increase of complete remission rates to 85% to 90% and overall survival rates to 40% to 50%.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The effect of allogeneic stem cell transplantation on outcome in younger acute myeloid leukemia patients with minimal residual disease detected by flow cytometry at the end of post-remission chemotherapy.

The absorption and permeation of oral D-Xylose, lactulose and mannitol were measured weekly from baseline until marrow recovery in adult recipients of idarubicin plus cytarabine for untreated acute myeloid leukaemia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Persistent eosinophilic infiltration of the myocardium in a child in complete remission of acute lymphoblastic leukemia and eosinophilia. Potential role in late cardiac disease?

This report describes the long-term (23 years) follow-up of a pediatric patient with acute lymphoblastic leukemia and eosinophilia who underwent multiple valve replacements.

An 8-year-old boy with this complex disease was admitted in January 1984 and treated with 6-week course of vincristine, L-asparaginase, and prednisolone, which induced complete remission.

The present study indicates that a subset of patients in complete remission of acute lymphoblastic leukemia and eosinophilia can show persistent myocardial eosinophilic infiltration and are at risk of late cardiac disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Homoharringtonine in combination with cytarabine and aclarubicin resulted in high complete remission rate after the first induction therapy in patients with de novo acute myeloid leukemia.

To assess the efficacy and toxicity of HAA regimen (homoharritonine 4 mg/m2/day, days 1-3; cytarabine 150 mg/m2/day, days 1-7; aclarubicin 12 mg/m2/day, days 1-7) as an induction therapy in the treatment of de novo acute myeloid leukemia (AML), 48 patients with newly diagnosed AML, aged 35 (14-57) years, were entered into this clinical study.

Eighty-three percent of patients achieved complete remission (CR), and the first single course of induction HAA regimen resulted in CR rate of 79%.

For all patients who achieved CR, the median time from the initiation of the induction therapy to the evaluation of the remission status was 32 days.

This study suggested that HAA regimen might be a well-tolerable, effective induction regimen in young adult patients with AML.

Despite the use of intensive chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT), complete remission and overall survival rates were less than 70% and 20%, respectively.

However, imatinib, in combination with conventional chemotherapy, has dramatically changed outcomes, producing approximately 95% complete remission and 50% overall survival with or without allogeneic HSCT.

Although allogeneic HSCT during first complete remission is still the first choice for feasible patients, post-HSCT imatinib therapy and imatinib plus chemotherapy combinations should also be studied.

New BCR-ABL tyrosine kinase inhibitors are expected to improve outcomes in imatinib-resistant leukemia.

Our hope is that, in the near future, Ph-positive ALL will become a leukemia in which allogeneic HSCT is offered only for relapsed or refractory cases.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Use of L-asparaginase in acute lymphoblastic leukemia: recommendations of the Polish Adult Leukemia Group.

Owing to the unique anti-cancer mechanism of action, L-asparaginase has been introduced to the multi drug chemotherapy in children and adults with acute lymphoblastic leukemia, which has contributed to significant improvement of therapy outcomes and to achieve complete remission in about 90% of patients.